Are your pets vaccines current?
Do you have pets medical records?
Medical records at another veterinary Practice?
Would you like us to call you for your appointment
All fees are due at the time services are rendered.
How did you become aware of our clinic?
If you have additional pets please fill out the following:
Please Read I understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Glendale Animal Hospital and that charges are due and payable at the time of service, unless other arrangements are made in advance. Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5% or 18% per annum. Any balance that I leave unpaid will be forwarded to Glendale Animal Hospital’s collection agency, and will incur a 25% collection fee for which I am liable, in addition to monthly finance charges.
I have read this statement and –